Cross-cultural validation of the Chinese version of the lean management scale for nursing services in hospitals

Abstract

Background Lean management has been increasingly applied in nursing services to improve workflow efficiency and reduce waste in care processes. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Lean Management Scale for Nursing Services in Hospitals (LMS-N) among Chinese clinical nurses. Methods A total of 2,127 clinical nurses were recruited from four tertiary hospitals in Liaoning Province, China, using convenience sampling. Following Brislin’s translation guidelines, the LMS-N was translated and culturally adapted into Chinese. Psychometric evaluation included item analysis, internal consistency and test–retest reliability, exploratory and confirmatory factor analyses, parallel analysis, convergent and discriminant validity, and measurement invariance testing. Results Parallel analysis and exploratory factor analysis supported a five-factor structure, explaining 62.609% of the total variance. Confirmatory factor analysis demonstrated acceptable model fit (CMIN/DF = 2.130, SRMR = 0.046, RMSEA = 0.032, GFI = 0.967, AGFI = 0.958, NFI = 0.971, IFI = 0.985, RFI = 0.967, CFI = 0.985). Reliability indices indicated satisfactory internal consistency (Cronbach’s α = 0.933; McDonald’s ω = 0.931) and test–retest reliability (0.880). Measurement invariance across gender, department, and educational attainment was supported. Conclusion The Chinese version of the LMS-N demonstrated acceptable reliability and validity among clinical nurses from tertiary hospitals in one province of China. The scale may be useful for assessing lean management implementation in nursing practice, although further validation in more diverse settings is warranted.